摘要
背景:胫骨平台骨折会抑制膝关节正常功能,严重损伤患者下肢功能,而早期诊断措施对预后效果具有关键作用。以往研究虽已存在多层螺旋CT三维重建技术对胫骨平台骨折诊断的相关报道,但将其诊断效果与X射线检查方式对比较为鲜见。目的:分析64排螺旋CT三维重建在胫骨平台骨折修复诊治中的应用效果,并与传统X射线诊治结果进行对比。方法:选择无锡市第九人民医院2012年10月至2013年10月收治的30例胫骨平台骨折患者,对患者进行64排螺旋CT扫描三维重建以及X射线片检查,对检查结果进行分析对比。CT扫描应用GE64排螺旋CT机,扫描范围为胫骨近端,三维重建间距为1 mm,完成扫描后上传工作平台完成图像重建。结果与结论:通过64排螺旋CT三维重建检查,胫骨平台骨折的程度、有无塌陷、碎骨片存在及移位等均可清晰显示,按照HOHI分型:8例Ⅰ型,7例Ⅱ型,4例Ⅲ型,5例Ⅳ型,3例Ⅴ型,3例Ⅵ型,确诊率为100%;X射线诊断结果显示有25例确诊,有3例为疑似诊断,2例不能确诊,确诊率为83%,两种方式确诊率比较差异有显著性意义(P<0.05)。患者经手术治疗后取得良好的修复效果,疗效优良率为93%。提示64排螺旋CT三维重建在胫骨平台骨折修复诊治中具有重要的应用价值,能清晰的将胫骨平台骨折的解剖形态特点展现出来,为提高修复效果提供重要依据。
BACKGROUND：Tibial plateau fracture wil inhibit the normal function of the knee joint, and severely damage lower extremity function. Early diagnostic measures play a key role in prognosis. Previous studies mainly focused on multislice spiral CT three-dimensional reconstruction for diagnosis of tibial plateau fractures, but it is rare to compare diagnostic results and X-ray inspection methods. OBJECTIVE：To analyze the application effect of 64-row spiral CT three-dimensional reconstruction in the repair, diagnosis and treatment of tibial plateau fractures, and compare with diagnostic outcomes of traditional X-ray. METHODS：A total of 30 patients with tibial plateau fractures were selected from Ninth People’s Hospital of Wuxi City from October 2012 to October 2013. Patients were subjected to 64-row spiral CT scanning, three-dimensional reconstruction and X-ray plain film inspection. The inspection results were analyzed and compared. CT scanning used GE64 row spiral CT. Scanning range was the proximal tibia. Spacing of reconstruction was 1 mm. After completing the scan, data were uploaded to a working platform, and image reconstruction was completed. RESULTS AND CONCLUSION：Through 64-row spiral CT three-dimensional reconstruction, the degree of tibial plateau fractures, colapse, broken bones and displacement were clearly shown. According to the HOHI classification method： eight cases were type I, seven cases were type II, four cases were type III, five cases were type IV, three cases were type V, and three cases were type VI. The diagnosis rate was 100%. X-ray results showed that 25 cases were diagnosed, 3 cases were suspected diagnosis, 2 cases could not be confirmed. The diagnosis rate was 83%. Significant differences in the diagnosis rate were detectable between the two methods （P 〈 0.05）. After surgical treatment, good clinical effects were found in patients. The excelent and good rate was 93%. These data suggested that 64-row spiral CT three- dimensional reconstruction has important application value in the diagnosis and treatment of tibial plateau fractures, can clearly show the characteristics of the anatomical morphology of fracture of tibial plateau, and provide important evidence for elevating repair effect.
出处
《中国组织工程研究》
CAS
北大核心
2015年第4期612-617,共6页
Chinese Journal of Tissue Engineering Research
